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Biomedical subjects

A Alperovitch

Publications and source records attributed to A Alperovitch.

At least 55 records · Page 3Linked to original sources
PubMed1989

Absence of familial association between dementia of Alzheimer type and Down syndrome.

The aim of this study was to test whether there is an excess of dementia of Alzheimer type (DAT) cases in Down syndrome (DS) relatives. We conducted a case-control study in families of DS children with classical trisomy 21. A control group was constituted of families of children referred to the same hospital for benign diseases. Families of 188 DS children and 185 controls were recruited. We obtained vital statistics on 1,850 (response rate 82%) grandparents and great-grandparents in the DS group and 1,525 (69%) in the control group. Rates of possible severe dementia were calculated on ancestors over age 60 years with available data on mental function, 1,336 in the DS group and 1,113 in the control group. Rates of possible severe dementia were similar in the two groups: 5.6% (78 cases) in DS and 6.2% (66 cases) in control. Dementia with insidious onset suggestive of DAT was observed in 2% (28 cases) of DS ancestors and 2.6% (28 cases) of control ancestors. Our results argue against an excess of dementia cases with insidious onset suggestive of DAT in families of children with classical trisomy 21.

Age Factors↗
PubMed1989

Risk factors in multiple sclerosis: a population-based case-control study in Hautes-Pyrénées, France.

A population-based study of the prevalence and risk factors of multiple sclerosis (MS) was conducted in the Hautes-Pyrénées, the southwestern region of France. The prevalence rate per 100,000 was equal to 40. Data on the past medical history of 63 MS patients and matched controls were collected. The frequency and age at occurrence of common childhood infections were similar for both the MS cases and controls. There was no difference between the frequency of vaccination for MS patients and for controls. However, the age at which MS patients were immunized against poliomyelitis was significantly higher than the corresponding age for controls (15.8 years versus 8.9 years, P less than 0.01). Antibody titers for various viruses were measured. The mumps antibody titer was significantly higher in the MS patients than in the controls. Also, MS patients tended to have higher titers for measles antibodies.

Adult↗
PubMed1989

Increasing trend of ALS in France and elsewhere: are the changes real?

We analyzed 9,005 deaths from amyotrophic lateral sclerosis recorded in France between the years 1968 and 1982. The overall adjusted mortality rates were 1.45/100,000 for men and 0.90/100,000 for women. We found excess male mortality in every age group. Age-specific mortality rates increased with age until 65-74 years and then declined in the older population. There was no meaningful regional pattern. We found a substantial increase in ALS mortality over time: the adjusted rates (per 100,000) in the period 1968 to 1971 were 1.11 for men and 0.63 for women. In the period 1979 to 1982, the corresponding figures were 1.92 and 1.12. The increase was mainly due to persons over 55 years of age and affected mostly the women during the first part of the study (1968 to 1978). In the recent years, increase appeared similar in both sexes. The temporal trends are consistent across studies in different countries.

Adult↗
PubMed1989

Memory complaints in the elderly: a study of 367 community-dwelling individuals from 50 to 80 years old.

State of memory was evaluated by a Memory Clinic in 367 community-dwelling patients aged from 50 to 80. They performed an exhaustive subjective evaluation including: severity of memory complaint, social status, activity scale, subjective Memory score, Zung's anxiety and depression scales and Well Being Questionnaire. Objective memory performance was evaluated by a complete memory scanning leading to a Global Objective Memory Score. No relationship was found between severity of memory complaints and age, sex, educational level, marital status, living alone or in family, and memory tests performance. More severe complaints were reported in people with poor social network, negative stereotypes on aging, and poor affective status. A strong correlation was found between severity of memory complaints and scores in self-reporting depression questionnaire, even in people with low depression scores.

Aged↗
PubMed1988

[Prognostic factors in resuscitation].

The outcome from intensive care is known to be influenced by such factors as age, previous health status, severity of the disease and diagnosis. In order to assess the influence of each individual factor, 3,687 patients from 38 French intensive care units were studied. For each patient were recorded: age, simplified acute physiological score (SAPS), previous health status, diagnosis, type of intensive care unit (medicine, scheduled or elective surgery) and immediate outcome. Each of these factors was found to influence the immediate survival rate. A multivariate analysis ranked the factors in the following order: SAPS, age, type of intensive care unit and previous health status. Diagnosis played a role in the prognosis since with a 10-15 points SAPS mortality was nil for drug overdose, 12 per cent for chronic obstructive pulmonary disease and 38 per cent for cardiogenic shock. However, a single diagnosis was made in only 37 per cent of the patients, as against 3 diagnoses in 17 per cent and 4 diagnoses or more in 7 per cent. When the type of intensive care unit was considered, the mean death rate was 20 per cent in medicine, 27 per cent in scheduled surgery and 5 per cent in elective surgery (P less than 0.001). Since this study showed a definite influence of each of the four factors on immediate survival, intensive care patients can be described and classified according to this system. However, it must be stressed that individual prognoses are extremely vague.

Age Factors↗
PubMed1987

[South-Eastern France, a high risk area for multiple sclerosis?].

A questionnaire-based prevalence study was conducted in the Chalon-sur-Saône and Avignon areas, in the Rhône-Saône valley, France, to determine the frequency of multiple sclerosis. These areas are 300 km apart and lie on the 47 degrees and 44 degrees North parallels respectively. Age-adjusted prevalence rates on March 20, 1984 were 58.5 and 48.6 per 100,000 inhabitants respectively. There was no significant difference between the two areas. These preliminary data suggest that south-eastern France, as represented by Avignon, may fall within the high risk area for multiple sclerosis.

France↗
PubMed1987

Influence of patients' age on survival, level of therapy and length of stay in intensive care units.

The influence of patients' age on survival, level of therapy and length of stay was analyzed from data collected in 792 consecutive admissions to eight intensive care units. Mortality rate increased progressively with age; over 65 years of age, it was more than double that of patients under 45 years (36.8% versus 14.8%). However, mortality rate in patients over 75 years was equal to that observed in the 55 to 59 years group. There was a significant relationship between age and acute physiology score (APS) and the influence of age upon outcome decreased when APS increased. The number of TISS (therapeutic intervention scoring system) points delivered to patients increased slightly but significantly with age (r = 0.14). Standard care was responsible for the main part of this increase. Both in survivors and in non-survivors the length of stay was not different comparing the stay of the oldest patient with that of the younger age groups. We conclude that, in ICU patients, age is an important factor of prognosis but not as important as the severity of illness, and that there is no major difference in outcome of patients over 65 years of age compared to the entire study group of ICU patients.

Adolescent↗
PubMed1987

Excessive daytime somnolence in young men: prevalence and contributing factors.

To investigate the prevalence of excessive daytime somnolence and contributing factors, 58,162 draftees between 17 and 22 years of age, registered in two selection centers of the French army, were screened by means of a 17-item questionnaire. In response, 8,201 subjects (14.1%) reported occasional daytime sleep episodes, 2,210 (3.8%) one or two daily episodes, and 640 (1.1%) more than two daily episodes. Of the total sample, five percent or 2,933 considered these sleep episodes to affect their lives. Different possible factors of daytime sleep episodes were investigated, including hours of nocturnal sleep, sleep-wake schedule, sleep difficulties, use of hypnotics, snoring, and occurrence of cataplexy. A strong association was found between these factors and excessive daytime somnolence. A stepwise multivariate analysis was performed on five of these factors: hours of nocturnal sleep, sleep-wake schedule, sleep difficulties, use of hypnotics, and snoring. All five factors were shown to be independently related to excessive daytime somnolence and were ranked in the following descending order: use of hypnotics, sleep difficulties, irregular sleep-wake schedule, snoring, and hours of sleep.

Adolescent↗
PubMed1987

[Epidemiology of Alzheimer's type dementia].

Although still fragmentary, currently available epidemiologic data allow an analysis of the magnitude of the problem raised by Alzheimer type dementia. Its prevalence after 65 years of age varies between 1 and 5.8 p. 100, increasing markedly with advancing age to reach, from about 0.1 p. 100 between 55 and 65 years, 1 p. 100 between 65 and 74 and 10 p. 100 beyond 85 years. Based on these data it can be estimated that there are presently about 300,000 patients 60 years of age or over with Alzheimer type dementia (ATD) in France. The only risk factor for ATD identified at the present time is age but a family history of dementia could constitute a further risk factor for the disease. Progress in the field of epidemiology of ATD requires the development and validation of diagnostic criteria and standardized measuring instruments, allowing comparison of results of studies conducted by different teams in different countries, nearly impossible up to the present.

Aged↗
PubMed1985

[Tomodensitometry and cerebral scintigraphy. Respective indications].

The comparative values of computerized tomography and radionuclide scan for the diagnosis of brain lesions were assessed on a series of 550 patients. A number of indications for each of these two methods have emerged from our results and from those found in the literature. The biases encountered in this type of study are discussed, and a "decision-making flow-chart" is proposed. The procedure of choice is computerized tomography in patients with suspected tumour or intracerebral haematoma, and radionuclide scan in those with suspected subdural haematoma or superficial cerebrovascular disease. The usefulness of clinical examination to determine precisely which of these two methods should be used cannot be overstressed.

Brain↗
PubMed1985

Computer-aided selection of diagnostic tests in jaundiced patients.

A model has been developed for ordering diagnostic tests in jaundiced patients. The system proceeds in two steps: (i) diagnostic hypotheses are calculated for each patient from the results of physical examination and routine biological investigations; (ii) given these hypotheses, the most efficient test (out of 22) for reaching the final diagnosis is selected using four criteria: diagnostic value, risk, financial cost, and time in obtaining the result. This model was tested in 62 patients. In 43 of them (69%), the selected test was sufficient for reaching a diagnostic accuracy of 100%. In this group of patients, a mean of 3.7 (range 1-6) tests per patient was ordered by physicians. In the 19 remaining patients, the selected test was not sufficient for the final diagnosis, thus requiring a multiple choice process. It is suggested that such a system could help physicians to improve the care of patients by more efficient ordering of diagnostic tests.

Adolescent↗
PubMed1984

A simplified acute physiology score for ICU patients.

We used 14 easily measured biologic and clinical variables to develop a simple scoring system reflecting the risk of death in ICU patients. The simplified acute physiology score (SAPS) was evaluated in 679 consecutive patients admitted to eight multidisciplinary referral ICUs in France. Surgery accounted for 40% of admissions. Data were collected during the first 24 h after ICU admission. SAPS correctly classified patients in groups of increasing probability of death, irrespective of diagnosis, and compared favorably with the acute physiology score (APS), a more complex scoring system which has also been applied to ICU patients. SAPS was a simpler and less time-consuming method for comparative studies and management evaluation between different ICUs.

Health↗
PubMed1984

[Can therapeutic trials serve as a model for the evaluation of diagnostic methods?].

Many health care professionals think that diagnostic technologies must be assessed as treatments are and that controlled diagnostic trials must be organized for evaluation of diagnostic tests. There are many differences between these two types of trials relating with: unfeasibility of blind judgments, biases due to requesting of diagnostic tests in addition to technologies to be compared, number of patients required for a sufficiently powerful statistical analysis, diverging interest of the various clinical teams involved into the assessment. A different approach using simulation methods and decision trees appears more appropriate in the evaluation of diagnostic technics.

Clinical Trials as Topic↗
PubMed1983

[Use of a severity index in 8 multidisciplinary resuscitation centers].

A universal severity index for acutely ill patients was applied to 794 acute patients treated in eight medical and surgical French intensive care units located in teaching or community hospitals either in Paris or in provincial towns. Measured on the first day in hospital from objective numerical data, the index proved reliable and correlated well with hospital mortality and the sustained therapeutic efforts of the first 24 hours. It could be used in multicentre studies to compare outcomes and evaluate new treatments.

Disease↗